EP0315338B1 - Surgical instrument - Google Patents

Surgical instrument Download PDF

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Publication number
EP0315338B1
EP0315338B1 EP19880309785 EP88309785A EP0315338B1 EP 0315338 B1 EP0315338 B1 EP 0315338B1 EP 19880309785 EP19880309785 EP 19880309785 EP 88309785 A EP88309785 A EP 88309785A EP 0315338 B1 EP0315338 B1 EP 0315338B1
Authority
EP
European Patent Office
Prior art keywords
rod
bone
guide
adapted
means
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP19880309785
Other languages
German (de)
French (fr)
Other versions
EP0315338A1 (en
Inventor
Roger Jellicoe
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Smith and Nephew Inc
Original Assignee
Smith and Nephew Richards Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to AUPI499187 priority Critical
Priority to AU4991/87 priority
Application filed by Smith and Nephew Richards Inc filed Critical Smith and Nephew Richards Inc
Priority claimed from AT88309785T external-priority patent/AT85202T/en
Publication of EP0315338A1 publication Critical patent/EP0315338A1/en
Application granted granted Critical
Publication of EP0315338B1 publication Critical patent/EP0315338B1/en
Anticipated expiration legal-status Critical
Application status is Expired - Lifetime legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1764Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1675Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B2017/1602Mills
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T409/00Gear cutting, milling, or planing
    • Y10T409/30Milling
    • Y10T409/306216Randomly manipulated, work supported, or work following device
    • Y10T409/306384Randomly manipulated, work supported, or work following device with work supported guide means
    • Y10T409/30644Randomly manipulated, work supported, or work following device with work supported guide means to guide tool to move in arcuate path

Description

  • The invention relates to surgical instrumentation for use in cutting bones adjacent joints. The instrumentation is of particular application in total knee arthroplasty.
  • In carrying out total knee arthroplasty it is necessary to cut both the distal femoral and proximal tibial bones to remove the surface of articulation therefrom. Such surgery is commonly required in degenerative bone disease of the joints or in chronic arthritis.
  • The major difficulty encountered with instrumentation presently available is that it is often very difficult to obtain precise flat bone cuts. For optimum functional performance and long term results cementable or cementless total knee replacement components demand precise flat bone cuts resulting in an even distribution of load at the implant/bone interface. Almost all prior art systems provide for cuts to be made with a narrow oscillating saw blade over or through a metal jig. The flexibility of the blade allows the saw to deviate, often taking the path of least resistance when passing through sclerotic bone and resulting in inaccurate cuts or uneven surfaces.
  • EP-A-0121142 discloses one such prior art device. To act as a guide during cutting a cutting guide is rigidly secured to an intramedullary rod. The cutting implement, an oscillating saw, then has to be manipulated relative to the cutting guide and the rod so as to make the complete cut.
  • The prior art device disclosed in US-A-4487203 also comprises a cutting guide rigidly secured to an intramedullary rod. Again, the cutting implement, a saw, has to be manipulated relative to the fixed guide in order to effect the full cut.
  • The arrangements of EP-A-0121142 and US-A-4487203 both have the disadvantage mentioned above of allowing for the making of inaccurate cuts, due to the need for the surgeon to manipulate the cutting implement around a rigidly fixed cutting guide.
  • According to the present invention there is provided surgical instrumentation for use in cutting bones on one or both sides of a joint, comprising a rod adapted for insertion into the medullary canal of a bone to be cut, means for locking the rod into a desired position within the bone to be cut, guide means for positioning a bone cutting implement in a desired position relative to the bone, and means for locking the guide means relative to the rod to prevent movement of the guide means along said axis, characterised in that the guide means is engageable with the rod to carry the bone cutting implement in said desired position for free rotation of the guide means and bone cutting implement about the longitudinal axis of the rod.
  • With the instrumentation of the present invention the bone cutting implement is carried by the guide means and the guide means is rotatable with the bone cutting implement about the longitudinal axis of the rod (whilst being held axially fast). This arrangement allows for the bone to be cut accurately.
  • In a preferred embodiment of the present invention the bone cutting implement consists of a rigid router or side cutting twist drill and, in use, prior to the cutting of the bone with the rigid router a hollow mill is inserted through the guide means and a hole bored in the bone, prior to the insertion of the rigid router.
  • In order that the nature of the present invention may be more clearly understood a preferred form thereof will now be described with reference to the following drawings, in which:
    • Fig. 1 is a side elevational view of a rod for insertion into the medullary canal of a human tibia for use as part of the surgical instrumentation according to the present invention;
    • Fig. 2 is a further side elevational view of the rod of Fig. 1;
    • Fig 3 is a side elevational view similar to Fig. 1 of a rod for use as part of the surgical instrumentation according to the present invention but for insertion into the medullary canal of a human femur;
    • Fig. 4 is a side elevational view of a locking nail drill guide for use as part of the surgical instrumentation according to the present invention to which is attached a depth guide adapted for use when the instrumentation is used on a human tibia;
    • Fig. 5 is a side elevational view of a twist drill with depth stop for use in the drill guide shown in Fig. 4;
    • Fig. 6 is a partly cut away side elevational view of a router guide with locking mechanism for use as part of the surgical instrumentation according to the present invention;
    • Fig. 7 is a side elevational view of a hollow mill for use in the router guide of Fig. 6;
    • Fig. 8 is a side elevational view of a router or side cutting drill for use in the router guide of Fig. 6;
    • Fig. 9 is a side elevational view of a locking nail for use as part of surgical instrumentation according to the present invention;
    • Fig. 10 is a longitudinal sectional view through a human knee joint showing part of the surgical instrumentation being used to form a hole to receive a locking nail to retain the rod in position in the medullary canal of the patient's femur;
    • Fig. 11 is a longitudinal sectional view through the human knee joint of Fig. 9 showing the router guide and router in position on the rod secured in the medullary canal;
    • Fig. 12 is a longitudinal sectional view through the human knee joint of Fig. 9 showing part of the surgical instrumentation being used to form a hole to receive a locking nail to retain the rod in position in the medullary canal of the patient's tibia.
  • The surgical instrumentation according to the preferred embodiment of the invention adapted for use in a total knee arthroplasty comprises an intramedullary rod 10, a locking nail drill guide 11, a drill 12, locking nails 13, a router guide 14, a hollow mill 15, and a router or side cutting drill 16.
  • The intramedullary rod 10A shown in Figs. 1 and 2 is adapted for insertion into the human tibial medullary canal and comprises an elongate shaft 19 having at one end a full spherical radius 17 and at the other end a cylindrical portion 18 of reduced diameter. The portion 18 and the shaft 19 are in axial alignment and join at a shoulder 21. The junction of shaft 19 and cylindrical portion 18 is formed with a pair of diametrically opposed flats 22. The shaft 19 tapers inwardly slightly along its length from the shoulder 21 to the fully radiused end 17. A diametrically aligned hole 23 extends through the shaft 19 at right angles to flats 22 adjacent shoulder 21 The free end of the portion 18 is formed with a threaded axially extending hole 24 adapted to receive a locking bolt 25 (see Figs. 10, 11 and 12).
  • An intramedullary rod 10B for use in the human femoral medullary canal is shown in Fig. 3 and is identical with rod 10A shown in Figs. 1 and 2 with the exception that the axes of the cylindrical portion 18 and the shaft 19 are offset by 7° to compensate for the fact that the articular surfaces of the human femur are offset from its axis by approximately that amount due to the femur angling in from the hips to the knee. It will be recognized by persons skilled in the art that in some cases the angle between the axes of the shaft 19 and the cylindrical portion 18 may be varied from the 7° angle described to suit a particular patient. It will be appreciated that the same rod 10B may be used for both the right and left legs by rotation about its long axis through 180°. The shaft 19 is a right cylinder rather than tapering due to the greater size of the medullary canal.
  • The drill guide 11 includes a tubular body 26 adapted to be a close sliding fit on the portion 18 of the rod 19. The body 26 if formed at one end with pair of projections 27 adapted to engage with the flats 22 of the rod 10 and prevent relative rotation therebetween when the drill guide 11 is assembled on the rod 10. An arm 28 extends radially from the other end of body 26 and then is bent through 90° to extend parallel to body 26. At its free end arm 28 is carries a tubular guide member 29. The guide member 29 is so positioned to guide the drill 12 through the hole 23 in the rod 10 in use.
  • The drill guide 11 is adapted for use with a depth guide which limits the extent to which the rod 10 may be inserted into the medullary canal and thus the amount of bone cut from the articular surface to be replaced. In the case of a femur the guide means may comprise a plate 31 (as seen in Fig. 10) having a recess 32 adapted to fit about the body 26 of the drill guide 11 and be retained thereon by bolt 25. The plate 31 is, in use, adapted to bear against one or both of the femoral condyles and ensure that a fixed amount of bone is removed from the femur in all cases.
  • In the case of the tibia it may be desirable to remove the minimum amount of bone and for this reason a different type of depth guide is used. In this case the depth guide comprises a collar 33 (see Figs. 4 and 12) rotatably mounted on the outside of the body 26 of the drill guide 11 and adapted to bear against the arm 28. The collar 33 carries an L-shaped stylus 34. The stylus 34 has a long arm 35 slidably disposed in a bore in the collar 33 normal to the axis thereof. A short arm 36 of the stylus 34 has a pointed tip adapted to be abutted against the lowest point on the tibial articular surfaces. The instrumentation is then adapted to cut the bone of the tibia down to a plane a fixed distance beyond the low point abutted by the stylus 34.
  • The router guide 14 comprises a tubular body 37 adapted to be a close sliding fit on the portion 18 of the rod 10 and to be rotatable thereabout. An arm 38 extends radially from one end of the body 37 and is bent through 90° to extend parallel to body 37. At its free end the arm 38 carries a tubular guide member 39. The tubular guide carries a radially arranged locking pin 41 which is mounted in a radially arranged tubular housing 42. A spring 43 in the housing and surrounding the pin 41 urges the free end of pin 41 radially inwardly into the bone of the tubular guide member 39. The pin 41 includes at its outer end a knurled knob 44 adapted to abut against the radially outer end of the housing 42. The underside of the knob 44 is formed with a boss 45 adapted to be normally received in a recess in the end of housing 42. If it is desired to maintain the free end of the pin 41 retracted from the bore of the tubular guide member 39 the pin 41 may be pulled radially outwardly and rotated such that boss 45 bears against the outer end of housing 42. The body 37 of the router guide 14 is formed with a radial hole 46 in axial alignment with the bore of the tubular guide member 39.
  • The hollow mill 15 includes a tubular body 47 having an array of cutting teeth around its free end. The body 47 axially abuts with a stem 48 adapted to be gripped by the chuck of a conventional orthopaedic drill. A stop collar 49 is formed on the mill 15 intermediate its ends. For cleaning purposes the mill 15 is fully canulated.
  • The router or side cutting drill 16 includes in axial alignment a stem 52 a cutting body 51 and a projection 53. The stem 52 includes a circumferential groove 54.
  • In use the knee joint is exposed in the normal way with the leg held in flexion. A twist drill, normally 3/8" diameter, is used to drill through the distal femoral cortical surface in the intra condylar notch region and in line with the medullary canal. This drill hole allows insertion of the rod 10B into the femoral medullary canal.
  • The rod 10B is assembled with the depth guide 31 and the locking nail drill guide 11 on the portion 18 of the rod 10B and held in place by the bolt 25. The rod 10B is then inserted into the femoral medullary canal and is rotated until the axis of the guide member 29 is at 90° to the anterior portion of the distal femur and the depth guide plate 31 parallel to the posterior aspect of the femoral condyles and with the angled offset appropriate for either the right or left leg as the case may be. If desired, a nail 13 may be inserted through a hole (not shown) in the depth guide plate 31 into the distal end of the femur to retain the drill guide 11 in the correct orientation relative to the femur.
  • The drill 12 is then introduced through the guide member 29 and caused tro rotate using a conventional orthopaedic drill. The drill 12 is then caused to drill through the femur until a stop collar 55 on the drill 12 abuts against the guide member 29. The drill 12 is then removed and a short nail 13 introduced into the hole so formed to temporarily retain the rod 10B in place in the bone. The depth guide 31 and the drill guide 11 may then be removed from the rod 10B and the short nail replaced by a longer such nail 13 which will extend through the hole 23 in the rod 10B and into the cancellous bone on the other side of the rod 10B.
  • The router guide 14 may then be positioned on the portion 18 of the rod 10B and rotatably retained thereon by bolt 25. The hollow mill 15 is then introduced through guide member 39 with the pin 41 withdrawn. The mill 15 is caused to rotate using a conventional orthopaedic drill and is driven through the bone or other tissue between the guide member 39 and the body member 37 of the router guide 14. After withdrawal of the mill 15 the router 16 is positioned in the guide member 39 with the projection 53 extending into the hole 46 in the body 37 of router guide 14 and the pin 41 extending into the groove 54 in the router 16. The router is then caused to rotate about its axis using a conventional orthopaedic drill. The router guide 14 is then caused to rotate as far as it can in either direction about the portion 18 of the rod 10. The router 16 cuts into and then through the bone on either side of the intra condylar notch. When the maximum possible arc of the cut has been made the whole of the surgical instrumentation is removed from the femur and the cut completed using an oscillating saw.
  • The procedure for resecting the tibia is similar to that for the femur with the exception that after the hole has been drilled through the proximal tibial cortical surface in line with the medullary canal it normally will be necessary to slightly enlarge the medullary canal with a reamer to accept the rod 10A. This enlargement is preferably carried out with a blunt ended reamer (not shown) having the shape of the rod 10A having longitudinally extending cutting blades along its sides. Such a reamer will ensure that the medullary canal is enlarged just enough to receive the rod 10A without lateral movement while not being likely to pierce the bone surrounding the canal.
  • The drill guide 11 is assembled with the depth guide 33. The stylus 34 is moved radially of the axis of rod 10 and rotated about it until the tip of the stylus 34 is in contact with the lowest point of the upper tibial surface. If desired styli of different lengths may be used or there may be a plurality of holes in the collar 33 through which the stylus 34 may be slid to allow the resection of the tibia to be effected at different distances below the level identified by the tip of the stylus. It is also possible to use the depth guide to establish the highest point on the tibia and to use that as a reference point from which to establish the cutting depth. The resection is then completed as described above.
  • The surfaces so formed on the femur and the tibia have been found to be substantially flat and well adapted to receive a total knee prosthesis subject to the making of such other cuts as are conventionally required to fit such a prosthesis.
  • The above-described preferred embodiment of the invention provides instrumentation which may be used to make substantially flat even cuts transversely to the long axis of the bone on either side of the joint.

Claims (7)

  1. Surgical instrumentation for use in cutting bones on one or both sides of a joint, comprising a rod (10) adapted for insertion into the medullary canal of a bone to be cut, means (13) for locking the rod into a desired position within the bone to be cut, guide means (14) for positioning a bone cutting implement in a desired position relative to the bone, and means (25) for locking the guide means relative to the rod to prevent movement of the guide means along said axis,
    characterised in that the guide means (14) is engageable with the rod to carry the bone cutting implement in said desired position for free rotation of the guide means and bone cutting implement about the longitudinal axis of the rod.
  2. Surgical instrumentation as claimed in claim 1, in which the instrumentation includes a guide means (11) adapted to guide a drill (12) to form a hole transversely of the bone to be cut to allow a pin, nail or like member (13), constituting the means for locking the rod into a desired position within the bone, to extend through a drilled hole in the bone, through a hole in the rod and into the bone on the other side of the rod.
  3. Surgical instrumentation as claimed in claim 1, in which the instrumentation includes depth limiting means (31, 33) to control the extent to which the rod (10) may be inserted into the medullary canal of the bone to be cut.
  4. Surgical instrumentation as claimed in claim 3, in which the depth limiting means comprises a plate (31) adapted to be connected to one end of the rod (10).
  5. Surgical instrumentation as claimed in claim 3, in which the depth limiting means (33) comprises a stylus (34) rotatably mounted on the rod and adapted to be moved radially relative thereto.
  6. Surgical instrumentation as claimed in claim 1, in which the guide means (14) includes a tubular body (37) adapted to closely surround an end portion (18) of the rod and to rotate thereabout while being restrained against movement axially of the rod.
  7. Surgical instrumentation as claimed in claim 1, in which the bone cutting implement comprises a router or side cutting drill (16) adapted to extend radially of the rod (10) and to be rotated about its own longitudinal axis.
EP19880309785 1987-10-21 1988-10-19 Surgical instrument Expired - Lifetime EP0315338B1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AUPI499187 1987-10-21
AU4991/87 1987-10-21

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
AT88309785T AT85202T (en) 1987-10-21 1988-10-19 A surgical instrument.

Publications (2)

Publication Number Publication Date
EP0315338A1 EP0315338A1 (en) 1989-05-10
EP0315338B1 true EP0315338B1 (en) 1993-02-03

Family

ID=3772512

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19880309785 Expired - Lifetime EP0315338B1 (en) 1987-10-21 1988-10-19 Surgical instrument

Country Status (6)

Country Link
US (1) US5047032A (en)
EP (1) EP0315338B1 (en)
JP (1) JPH0257247A (en)
CA (1) CA1326987C (en)
DE (2) DE3878156T2 (en)
ZA (1) ZA8807854B (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8915910B2 (en) 2008-03-31 2014-12-23 Applied Medical Resources Corporation Electrosurgical system
US9320563B2 (en) 2010-10-01 2016-04-26 Applied Medical Resources Corporation Electrosurgical instruments and connections thereto

Families Citing this family (57)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2164859C (en) * 1993-06-10 2005-11-29 Gary Karlin Michelson Apparatus and method of inserting spinal implants
FR2649604B1 (en) * 1989-07-11 1995-05-19 Laboureau Jacques Philippe TRACKING ancillary surgical instrument to the entrance and the direction of insertion of a neo femoral tunnel ligament in conditions of total isometry
US5171244A (en) * 1990-01-08 1992-12-15 Caspari Richard B Methods and apparatus for arthroscopic prosthetic knee replacement
US5344423A (en) * 1992-02-06 1994-09-06 Zimmer, Inc. Apparatus and method for milling bone
US5207680A (en) * 1992-05-11 1993-05-04 Zimmer, Inc. Front milling guide for use in orthopaedic surgery
US5312409A (en) * 1992-06-01 1994-05-17 Mclaughlin Robert E Drill alignment guide
US5417695A (en) * 1992-07-27 1995-05-23 Pfizer Hospital Products Group, Inc. Instrumentation for preparing a distal femur
US5951606A (en) * 1992-11-20 1999-09-14 Burke; Dennis W. Centering device for femoral implant and method and apparatus for implementation thereof
JPH08508175A (en) * 1992-11-20 1996-09-03 バーク,デニス・ダブリュー Thigh bone graft body color and placement device
US5702485A (en) * 1992-11-20 1997-12-30 Burke; Dennis W. Collared prosthetic device with centering fins
US5474559A (en) * 1993-07-06 1995-12-12 Zimmer, Inc. Femoral milling instrumentation for use in total knee arthroplasty with optional cutting guide attachment
CA2126627C (en) * 1993-07-06 2005-01-25 Kim C. Bertin Femoral milling instrumentation for use in total knee arthroplasty with optional cutting guide attachment
US5616146A (en) * 1994-05-16 1997-04-01 Murray; William M. Method and apparatus for machining bone to fit an orthopedic surgical implant
US8062377B2 (en) 2001-03-05 2011-11-22 Hudson Surgical Design, Inc. Methods and apparatus for knee arthroplasty
US5514139A (en) * 1994-09-02 1996-05-07 Hudson Surgical Design, Inc. Method and apparatus for femoral resection
US8603095B2 (en) 1994-09-02 2013-12-10 Puget Bio Ventures LLC Apparatuses for femoral and tibial resection
US5810827A (en) * 1994-09-02 1998-09-22 Hudson Surgical Design, Inc. Method and apparatus for bony material removal
US5597379A (en) * 1994-09-02 1997-01-28 Hudson Surgical Design, Inc. Method and apparatus for femoral resection alignment
US6695848B2 (en) * 1994-09-02 2004-02-24 Hudson Surgical Design, Inc. Methods for femoral and tibial resection
US5562674A (en) * 1995-02-27 1996-10-08 Zimmer, Inc. Intramedullary rod with guide member locator
US5593411A (en) * 1995-03-13 1997-01-14 Zimmer, Inc. Orthopaedic milling guide for milling intersecting planes
US5601563A (en) * 1995-08-25 1997-02-11 Zimmer, Inc. Orthopaedic milling template with attachable cutting guide
US5658293A (en) * 1995-10-10 1997-08-19 Zimmer, Inc. Guide platform associated with intramedullary rod
DE19544084C1 (en) * 1995-11-27 1997-05-28 Uwe Hollmann Instrumentation for bone-enhancing resection for insert of knee joint endo- or total endoprosthesis
US5653714A (en) * 1996-02-22 1997-08-05 Zimmer, Inc. Dual slide cutting guide
US5792167A (en) * 1996-09-13 1998-08-11 Stryker Corporation Surgical irrigation pump and tool system
US6342061B1 (en) 1996-09-13 2002-01-29 Barry J. Kauker Surgical tool with integrated channel for irrigation
US6280472B1 (en) 1997-07-23 2001-08-28 Arthrotek, Inc. Apparatus and method for tibial fixation of soft tissue
US8080058B2 (en) 2003-04-01 2011-12-20 Depuy Mitek, Inc. Method and apparatus for fixing a graft in a bone tunnel
EP1129677A3 (en) 2000-02-29 2003-04-02 Brehm, Peter Instrumentation for manufacturing the fixation surfaces for a knee joint endoprosthesis
US6517546B2 (en) * 2001-03-13 2003-02-11 Gregory R. Whittaker Method and apparatus for fixing a graft in a bone tunnel
US7195642B2 (en) 2001-03-13 2007-03-27 Mckernan Daniel J Method and apparatus for fixing a graft in a bone tunnel
US6482209B1 (en) 2001-06-14 2002-11-19 Gerard A. Engh Apparatus and method for sculpting the surface of a joint
US6723102B2 (en) 2001-06-14 2004-04-20 Alexandria Research Technologies, Llc Apparatus and method for minimally invasive total joint replacement
AT487428T (en) * 2002-02-12 2010-11-15 Alexandria Res Tech Llc Device for minimally invasive joint replacement total
US7175632B2 (en) * 2002-05-15 2007-02-13 Linvatec Corporation Cross-pin graft fixation instruments and method
US20040039395A1 (en) * 2002-05-24 2004-02-26 Coon Thomas M. Instruments for knee surgery and method of use
EP1555963A4 (en) 2002-10-23 2008-12-31 Mako Surgical Corp Modular femoral component for a total knee joint replacement for minimally invasive implantation
US20040153066A1 (en) * 2003-02-03 2004-08-05 Coon Thomas M. Apparatus for knee surgery and method of use
US7481814B1 (en) 2003-07-28 2009-01-27 Biomet Manufacturing Corporation Method and apparatus for use of a mill or reamer
US7364580B2 (en) * 2003-10-08 2008-04-29 Biomet Manufacturing Corp. Bone-cutting apparatus
US7588578B2 (en) 2004-06-02 2009-09-15 Facet Solutions, Inc Surgical measurement systems and methods
US7857814B2 (en) 2004-01-14 2010-12-28 Hudson Surgical Design, Inc. Methods and apparatus for minimally invasive arthroplasty
US8114083B2 (en) 2004-01-14 2012-02-14 Hudson Surgical Design, Inc. Methods and apparatus for improved drilling and milling tools for resection
US8021368B2 (en) 2004-01-14 2011-09-20 Hudson Surgical Design, Inc. Methods and apparatus for improved cutting tools for resection
US7815645B2 (en) 2004-01-14 2010-10-19 Hudson Surgical Design, Inc. Methods and apparatus for pinplasty bone resection
US20060030854A1 (en) 2004-02-02 2006-02-09 Haines Timothy G Methods and apparatus for wireplasty bone resection
US7608079B1 (en) 2004-03-05 2009-10-27 Biomet Manufacturing Corp. Unicondylar knee apparatus and system
US20060030855A1 (en) 2004-03-08 2006-02-09 Haines Timothy G Methods and apparatus for improved profile based resection
GB0411487D0 (en) * 2004-05-22 2004-06-23 Depuy Int Ltd Surgical jig
US8702714B2 (en) * 2006-03-09 2014-04-22 Microsoft Orthopedics Holdings Inc. Instruments for total knee arthroplasty
GB2475491A (en) * 2009-11-18 2011-05-25 Biomet Uk Ltd Alignment tool for a femoral drill guide
US8747410B2 (en) 2010-10-26 2014-06-10 Zimmer, Inc. Patellar resection instrument with variable depth guide
US9333069B2 (en) 2011-10-14 2016-05-10 Biomet Sports Medicine, Llc Method and apparatus for attaching soft tissue to bone
US9113982B1 (en) 2014-03-19 2015-08-25 GRS Guide System, Inc. Positioning and installing surgical drilling devices and related devices and systems
US9211165B2 (en) 2014-03-19 2015-12-15 GRS Guide System, Inc. Positioning and installing surgical drilling devices and related devices and systems
JP2017515645A (en) 2014-05-16 2017-06-15 アプライド メディカル リソーシーズ コーポレイション Electrosurgical system

Family Cites Families (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1083013A (en) * 1953-09-03 1955-01-04 Apparatus reamer spindle for the cutting of the bone along a plane? Republic relative to their axis
US4174746A (en) * 1977-10-31 1979-11-20 Brooks Walker Pile sizer
US4440168A (en) * 1981-08-31 1984-04-03 Warren Mark G Surgical device
US4487203A (en) * 1981-11-03 1984-12-11 Androphy Gary W Triplanar knee resection method
US4787383A (en) * 1985-12-19 1988-11-29 Howmedica, Inc. Prosthetic knee implantation
DE8208970U1 (en) * 1982-03-30 1982-09-09 Howmedica International, Inc. Zweigniederlassung Kiel, 2301 Schoenkirchen, De
US4421112A (en) * 1982-05-20 1983-12-20 Minnesota Mining And Manufacturing Company Tibial osteotomy guide assembly and method
US4467801A (en) * 1983-03-09 1984-08-28 Wright Manufacturing Company Method and apparatus for shaping a proximal tibial surface
US4474177A (en) * 1983-03-09 1984-10-02 Wright Manufacturing Company Method and apparatus for shaping a distal femoral surface
US4624250A (en) * 1983-06-24 1986-11-25 Queen's University At Kingston Instrument for elbow surface replacement arthroplasty
DE3470456D1 (en) * 1983-06-24 1988-05-26 Univ Kingston Apparatus for locating an elbow prothesis
US4509511A (en) * 1983-06-30 1985-04-09 Neufeld John A Method and apparatus for corrective osteotomy
DE3412362C1 (en) * 1984-04-03 1985-10-10 Karl Leibinger Device for the aligned introduction of a hole in a bone
DE3569666D1 (en) * 1984-12-26 1989-06-01 Nivarox Sa Device to locate in situ through-holes in a hollow pin that is implanted into the medullary canal for the retention of the fragments of a fractured bone
GB8516167D0 (en) * 1985-06-26 1985-07-31 Finsbury Instr Ltd Surgical tool
DE8528770U1 (en) * 1985-10-09 1985-12-05 Ortopedia Gmbh, 2300 Kiel, De
US4703751A (en) * 1986-03-27 1987-11-03 Pohl Kenneth P Method and apparatus for resecting a distal femoral surface
DD250255A1 (en) * 1986-06-27 1987-10-08 Veb Ratiotechnik Neuruppin,Dd Positioning device for the bone surgery, in particular locking nailing
US4841975A (en) * 1987-04-15 1989-06-27 Cemax, Inc. Preoperative planning of bone cuts and joint replacement using radiant energy scan imaging

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8915910B2 (en) 2008-03-31 2014-12-23 Applied Medical Resources Corporation Electrosurgical system
US9566108B2 (en) 2008-03-31 2017-02-14 Applied Medical Resources Corporation Electrosurgical system
US9320563B2 (en) 2010-10-01 2016-04-26 Applied Medical Resources Corporation Electrosurgical instruments and connections thereto

Also Published As

Publication number Publication date
ZA8807854B (en) 1989-07-26
CA1326987C (en) 1994-02-15
JPH0257247A (en) 1990-02-27
US5047032A (en) 1991-09-10
EP0315338A1 (en) 1989-05-10
DE3878156D1 (en) 1993-03-18
DE3878156T2 (en) 1993-05-27

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